2022-08-12T10:00:24-05:00 2021-09-30 410746749 CLIFTONLARSONALLEN LLP 10700 NORTHUP WAY SUITE 200 BELLEVUE WA 98004 990 2020-10-01 930223960 ASANTE ASAN 5417895590 2650 SISKIYOU BLVD MEDFORD OR 97504 GREGORY WOJTAL CAFO 5417895590 2022-08-01 1 GREGORY WOJTAL 999009999 KURT BENNION CPA P01469618 4252506100 0 AAL1 IAL1 2020 2022-09-23 18:48:47Z SCOTT KELLY 2650 SISKIYOU BLVD MEDFORD OR 97504 1791584079 0 X WWW.ASANTE.ORG X 1938 OR ASANTE EXISTS TO PROVIDE QUALITY HEALTHCARE SERVICES IN A COMPASSIONATE MANNER, VALUED BY THE COMMUNITIES WE SERVE. 11 10 6499 7422 5965939 0 1044492 16633691 900575807 975543262 25330238 71095006 1646191 3728568 928596728 1067000527 208994 400200 0 0 479090521 545461461 0 0 0 378091394 405399916 857390909 951261577 71205819 115738950 1862282938 2030793202 809393724 799275071 1052889214 1231518131 X ASANTE EXISTS TO PROVIDE QUALITY HEALTHCARE SERVICES IN A COMPASSIONATE MANNER, VALUED BY THE COMMUNITIES WE SERVE. 0 0 448495083 398950 678933446 ASANTE'S MAIN PROGRAM SERVICE ACCOMPLISHMENT IS THE OPERATION OF ASANTE ROGUE REGIONAL MEDICAL CENTER (ARRMC), A 378 LICENSED BED HOSPITAL LOCATED IN MEDFORD, OREGON. ARRMC WAS NAMED ONE OF THE TOP 100 HOSPITALS IN THE NATION BY IBM WATSON. IN ADDITION, THEY WERE NAMED ONE OF THE TOP 50 CARDIOVASCULAR HOSPITALS IN THE NATHION. THEY ALSO RECEIVED A 5-STAR RATING FROM CMS. LEAPFROG AWARDED THE HOSPITAL WITH AN "A" SAFETY SCORE. THE HOSPITAL ALSO EARNED THE PATIENT SAFETY EXCELLENCE, PULMONARY CARE EXCELLENCE, BARIATRIC SURGERY EXCELLENCE, VASCULAR SURGERY EXCELLENCE, LABOR AND DELIVERY EXCELLENCE AND OBGYN EXCELLENCE AWARDS FROM HEALTHGRADES. HEALTHGRADES ALSO NAMED ARRMC AS ONE OF THE 100 BEST IN AMERICA FOR SPINE SURGERY. KEY HOSPITAL INPATIENT SERVICES INCLUDE CANCER SERVICES, CARDIOVASCULAR SURGERY, AND INPATIENT CARDIAC CATHERIZATION LABORATORY, GENERAL MEDICINE, GENERAL SURGERY, GYNECOLOGY, NEONATOLOGY, NEUROSCIENCES, OBSTETRICS, ORTHOPEDICS, PEDIATRICS, AND UROLOGY SERVICES. OTHER INPATIENT SERVICES INCLUDE BEHAVIORAL HEALTH, REHABILITATION, AND CRITICAL CARE SERVICES, INCLUDING THE REGION'S ONLY LEVEL 3 NEONATAL INTENSIVE CARE UNIT. KEY OUTPATIENT SERVICES INCLUDE EMERGENCY SERVICES, AMBULATORY SURGERY, OUTPATIENT LABORATORY TESTING AND DIAGNOSIS, OUTPATIENT CARDIAC CATHERIZATION LAB, IMAGING, SLEEP SERVICES, HOSPICE, AND VARIOUS THERAPIES, INCLUDING BEHAVIORAL, OCCUPATIONAL, PHYSICAL, AND SPEECH. DURING FISCAL YEAR 2021, RRMC ADMITTED 15,225 PATIENTS FOR A TOTAL OF 100,284 PATIENT DAYS. IT ALSO HAD OVER 550,000 TOTAL OUTPATIENT VISITS AND DELIVERED 1,721 BABIES. THE EMERGENCY ROOMS TREATED 45,922 PATIENTS AND THE CHEMISTRY LABS PERFORMED OVER 2.4 MILLION TESTS. SURGICAL SERVICES PERFORMED 9,242 INPATIENT AND OUTPATIENT SURGERIES AT RRMC. OTHER STATISTICS AT RRMC INCLUDE 20,945 HOSPICE VISITS, 91,490 VISITS TO THE VARIOUS REHAB UNITS, AND OVER 151,000 VISITS TO IMAGING. 143337137 0 221254674 ASANTE'S SECOND LARGEST PROGRAM SERVICE ACCOMPLISHMENT BY EXPENSE IS THE OPERATION OF ASANTE THREE RIVERS MEDICAL CENTER (ATRMC), A 125 LICENSED BED HOSPITAL LOCATED IN GRANTS PASS, OREGON. ATRMC RECEIVED A GRADE "A" HOSPITAL SAFETY SCORE FROM LEAPFROG FOR THE SIXTH CONSECUTIVE YEAR. HEALTH GRADES NAMED THEM ONE OF THE 100 BEST HOSPITALS IN AMERICA FOR JOINT REPLACEMENT. HEALTHGRADES ALSO AWARDED THE HOSPITAL WITH PATIENT SAFETY EXCELLENCE. ADDITIONALLY, ATRMC RECEIVED A 5-STAR RATING FROM CMS. SOME OF THE KEY INPATIENT SERVICES AVAILABLE AT TRMC INCLUDE CANCER SERVICES, GENERAL MEDICINE, GENERAL SURGERY, GYNECOLOGY, OBSTETRICS, ORTHOPEDICS, AND PEDIATRICS. SOME OF THE KEY OUTPATIENT SERVICES INCLUDE EMERGENCY SERVICES, AMBULATORY SURGERY, OUTPATIENT LAB TESTING, CARDIOPULMONARY SERVICES, OUTPATIENT CARDIAC CATHERIZATION LAB, IMAGING AND VARIOUS THERAPIES INCLUDING PHYSICAL, OCCUPATIONAL, AND SPEECH. DURING THE FISCAL YEAR, TRMC ADMITTED 6,720 INPATIENTS FOR A TOTAL OF 28,171 PATIENT DAYS. THEY ALSO DELIVERED 748 BABIES AND HAD OVER 272,000 OUTPATIENT VISITS. THE CHEMISTRY LAB PERFORMED NEARLY 678,000 TESTS AND THE EMERGENCY ROOM SAW 41,769 PATIENTS. THERE WERE 5,965 SURGERIES PERFORMED DURING THE YEAR. TRMC'S REHAB DEPARTMENT HAD 30,567 VISITS AND THE VARIOUS IMAGING DEPARTMENTS HAD OVER 83,000 VISITS. 48876449 1250 75355142 ASANTE'S THIRD LARGEST PROGRAM SERVICE ACCOMPLISHMENTS BY EXPENSE ARE THE OPERATION OF ASANTE ASHLAND COMMUNITY HOSPITAL, A 49 LICENSED BED HOSPITAL LOCATED IN ASHLAND, OREGON AND THE OPERATION OF THE CORPORATE DIVISION. AACH ALSO RECEIVED A 5-STAR RATING FORM CMS. THE HOSPITAL ALSO RECEIVED AN "A" SAFETY SCORE FROM LEAPFROG. ASANTE HEALTH SYSTEM WAS NAMED ONE OF THE "15 TOP HEALTH SYSTEMS IN THE NATION" FOR THE NINTH YEAR IN A ROW BY TRUVEN HEALTH ANALYTICS. IN ADDITION, ASANTE WAS NAMED BEST IN STATE EMPLOYER BY FORBES. KEY INPATIENT SERICES AVAILABLE AT ACH INCLUDE GENERAL MEDICINE, GENERAL SURGERY, GYNECOLOGY AND OBSTETRICS. SOME THE KEY OUTPATIENT SERVICES INCLUDE EMERGENCY SERVICES, AMBULATORY SURGERY, OUTPATIENT LAB TESTING, IMAGING AND VARIOUS THERAPIES. DURING THE FISCAL YEAR, ACH ADMITTED 1,210 INPATIENTS FOR A TOTAL OF 7,471 PATIENT DAYS. THEY DELIVERED 238 BABIES AND HAD OVER OVER 41,000 OUTPATIENT VISITS. THE LAB PERFORMED OVER 191,000 TESTS, THE EMERGENCY ROOM SAW 9,118 PATIENTS AND, THERE WERE 1,899 SURGERIES PERFORMED DURING THE YEAR. ASANTE'S CORPORATE DIVISION HAS MADE GENEROUS CASH DONATIONS TO NUMEROUS NON-PROFIT ORGANIZATIONS. THESE DONATIONS HELP SUPPORT A VARIETY OF LOCAL PROGRAMS, SUCH AS THE MASLOW PROJECT WHICH PROVIDES RESOURCES TO HOMELESS YOUTH TO THE ANNUAL PEAR BLOSSOM FESTIVAL TO ENCOURAGE HEALTH THROUGH MOVEMENT. OTHER NOTABLE DONATIONS INCLUDE LOCAL FOODBANKS, SEXUAL ASSAULT RESPONSE TEAMS, SUICIDE PREVENTION AND YOUTH CAMPS. OFTEN, INDIGENT AND MEDICAID PATIENTS WILL SHOW UP AT THE EMERGENCY ROOM IN NEED OF SPECIALIZED MEDICAL CARE. IN ORDER TO ASSURE THAT UNASSIGNED INDIGENT AND MEDICAID PATIENTS HAVE SPECIALIZED CARE AVAILABLE TO THEM, ASANTE CREATED SOUTHERN OREGON TRAUMA AND EMERGENCY SERVICES (SOTES). SOTES CONTRACTS WITH LOCAL INDEPENDENT PHYSICIANS TO PROVIDE SPECIALIZED CARE TO THESE PATIENTS THROUGHOUT THEIR HOSPITAL STAY. THE PHYSICIAN BILLS SOTES, WHICH WILL REIMBURSE THE SPECIALIST AT MEDICARE RATES. SOTES OPERATES AT BREAKEVEN. EXPENSES ARE FULLY FUNDED AND REIMBURSED TO THE DOCTOR BY THE HOSPITALS. 640708669 1 1 0 1 0 0 0 0 0 1 1 0 0 1 1 1 0 1 0 0 0 0 0 0 0 0 1 1 1 0 1 1 0 0 0 0 0 1 0 0 0 1 0 0 0 0 1 1 1 1 0 0 1 644 0 6499 1 1 1 0 0 0 0 0 0 0 0 0 1 0 X 11 10 0 0 0 0 0 0 0 1 1 0 1 1 0 1 1 1 1 1 1 1 0 OR X X GREG WOJTAL 5417894549 2650 SISKIYOU BLVD MEDFORD OR 97504 DOUGLAS SCHMOR CHAIRPERSON 2.00 2.00 X X 0 0 0 PETER ANGSTADT PHD VICE CHAIRPERSON 2.00 0.00 X X 0 0 0 KEN TRAUTMAN TREASURER 2.00 0.00 X X 0 0 0 PATRICIA WINTERMUTE SECRETARY 2.00 2.00 X X 0 0 0 RAY COX TRUSTEE (THROUGH DEC 2020) 2.00 0.00 X 0 0 0 STEPHEN GAMBEE TRUSTEE 2.00 0.00 X 0 0 0 ANNE GOLDEN TRUSTEE 2.00 2.00 X 0 0 0 BRIAN GROSS MD TRUSTEE 2.00 2.00 X 0 0 0 JOE PASTRANO MD TRUSTEE 2.00 0.00 X 0 0 0 STEPHEN ROE TRUSTEE 2.00 2.00 X 0 0 0 SANDRA SLATTERY TRUSTEE 2.00 0.00 X 0 0 0 THOMAS TUREK MD TRUSTEE 2.00 0.00 X 0 0 0 SCOTT KELLY PRESIDENT & CEO 40.00 2.00 X 1192488 0 32728 GREG WOJTAL CAFO 40.00 2.00 X 703672 0 39180 MICK ZDEBLICK RRMC CEO 40.00 0.00 X 600840 0 41948 JAMES GREBOSKY CMO & ACH CEO 40.00 1.00 X 606044 0 48767 LEE MILLIGAN MD CIO 40.00 0.00 X 544889 0 44270 WIN HOWARD TRMC CEO 40.00 0.00 X 479205 0 49145 DENNIE CONRAD CSO 40.00 0.00 X 452808 0 43538 JENNIFER HALL MD MEDICAL DOCTOR 40.00 0.00 X 405400 0 47590 ERIC LOELIGER MD VP, MEDICAL AFFAIRS - TRMC 40.00 1.00 X 529046 0 52820 COURTNEY WILSON MD MEDICAL DOCTOR 40.00 0.00 X 481254 0 47424 CHRIS DAVID MD MEDICAL DOCTOR 40.00 2.00 X 411131 0 47676 DANIELLE HOLTZ MD MEDICAL DOCTOR 40.00 0.00 X 404293 0 26480 ROY VINYARD FORMER PRESIDENT & CEO 0.00 0.00 X 223096 0 34330 SHEILA CLOUGH FORMER ACH CEO 0.00 0.00 X 226379 0 27556 7260545 0 583452 928 1 1 0 HEMATOLOGY ONCOLOGY ASSOCIATES 2828 E BARNETT ROAD MEDFORD OR 97504 ONCOLOGY SERVICES 22879101 SOUTHERN OREGON CARDIOLOGY LLC 520 MEDICAL CENTER DR 200 MEDFORD OR 97504 CARDIAC SERVICES 20800371 FOCUSONE SOLUTIONS LLC 13609 CALIFORNIA STREET SUITE 420 OMAHA NE 68154 STAFFING SERVICES 20756457 ANESTHESIA ASSOCIATES OF MEDFORD 842 E MAIN STREET MEDFORD OR 97504 PHYSICIAN SERVICES 18157200 SOUTHERN OREGON HOSPITALISTS 2640 E BARNETT ROAD MEDFORD OR 97504 PHYSICIAN SERVICES 6521471 38 3247736 13191123 194832 16633691 HOSPITAL SERVICES 622110 954654988 952318911 2336077 OTHER OPERATING INCOME 900099 15410028 15410028 NUTRITION SERVICES 621990 3785740 3785740 JOINT VENTURE INCOME 621990 1692506 1692506 975543262 18251243 18251243 2039527 1962885 76642 76642 76642 766341688 16151 713079634 434442 53262054 -418291 52843763 52843763 12736453 9106591 3629862 3629862 MISCELLANEOUS INCOME 900099 22064 22064 22064 1067000527 973207185 5965939 71193712 400200 400200 3931523 3931523 386480263 264620323 121859940 19479827 14579129 4900698 105549384 59435287 46114097 30020464 22194495 7825969 5283678 5283678 277597 277597 111852 111852 2011837 2011837 60539836 54105459 6434377 682723 12500 670223 4485945 692222 3793723 41011272 2560175 38451097 11089791 1200588 9889203 916692 412750 503942 76684 46951 29733 5290596 5290596 42355896 724561 41631335 -182598 -182598 MEDICAL SUPPLIES 189579527 189186228 393299 UBI TAXES 15000 15000 BAD DEBT EXPENSE 15226195 15231954 -5759 REPAIRS & MAINTENANCE 12893433 8255569 4637864 13733960 5221039 8512921 951261577 640708669 310552908 0 169197038 115625404 22205306 110447687 146857497 0 0 18953285 23877193 17852355 16208709 14249891 17619928 1021985682 516481666 364755623 505504016 672373519 770218264 5715598 5617774 12195 12195 488725747 407046916 1862282938 2030793202 26125884 37530803 538921038 535733089 32345718 34439991 212001084 191571188 809393724 799275071 X 1052889214 1231518131 1052889214 1231518131 1862282938 2030793202 115738950 62889968 0 X 0 1 X 1 1 1 X RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED RESTRICTED 0 0 0 0 0 1 57852 0 0 1 54000 111852 0 PART II-B, LINE 1: ASANTE MAINTAINS MEMBERSHIPS IN THE AMERICAN HOSPITAL ASSOCIATION (AHA) AND OREGON ASSOCIATION OF HOSPITALS AND HEALTHCARE SYSTEMS (OAHHS). DURING THE FISCAL YEAR, ASANTE PAID MEMBERSHIP DUES TO THE AHA AND OAHHS OF $90,687 AND $263,728 RESPECTIVELY. 14.12% OF OAHHS DUES AND 22.73% OF AHA DUES WENT FOR LOBBYING PURPOSES. THUS, ASANTE MADE INDIRECT LOBBYING EXPENDITURES OF $57,852 THROUGH ITS MEMBERSHIP DUES. ALSO, ASANTE PAID JOHN WATT AND ASSOCIATES (JWA) $54,000 FOR SPECIFIC ISSUES LOBBYING DURING THE TAX YEAR. JWA IS AN ADVOCATE FOR ASANTE AND SPECIALIZES IN BALLOT PROPOSITIONS AFFECTING THE HEALTHCARE INDUSTRY. 26942473 286934 402584 162088 27469903 24115278 716219 2245042 134066 26942473 21832879 239166 2197771 154538 24115278 21035987 96879 1118497 418484 21832879 19768780 1025379 712656 470828 21035987 0.02230 0.24220 0.73550 0 1 1 31390293 31390293 398556895 223806057 174750838 42637553 8109136 34528417 368087537 284566473 83521064 181313404 181313404 505504016 INTERCOMPANY RECEIVABLE 187371265 ASSETS RESTRICTED AS TO USE 198119696 OTHER ASSETS 21555955 407046916 SELF-INSURANCE RESERVE 23308254 REIMBURSEMENTS DUE TO GOVT AGENCIES & THIRD PARTIES 13787847 PAYROLL / BENEFITS PAYABLE 52100992 OTHER LIABILITIES 102374095 191571188 X PART V, LINE 4: THE ASANTE FOUNDATION, A 501(C)(3) ORGANIZATION, IS DIRECTLY RELATED TO AND CONTROLLED BY ASANTE. IT IS IDENTIFIED ON SCHEDULE R, PART II AS A RELATED TAX-EXEMPT ORGANIZATION. THE ASANTE FOUNDATION MAINTAINS THE ASSETS OF 15 DIFFERENT ENDOWMENTS WITH A NET WORTH OF OVER $26.0 MILLION. THE CORPUS OF THE ENDOWMENTS IS TO REMAIN INTACT AND INVESTED IN MARKETABLE SECURITIES AND OTHER FINANCIAL INSTRUMENTS. AT THE END OF EACH FISCAL YEAR, ANY INVESTMENT INCOME GENERATED FROM THE ENDOWMENTS IS RELEASED TO ASANTE. THE INCOME RECEIVED IS USED TO SUBSIDIZE NUMEROUS PROGRAMS, INCLUDING THE RRMC HOSPICE, PHYSICIAN AND NURSING EDUCATION, CHILDREN'S HEALTH, ONCOLOGY PROGRAMS, AND SUPPORT OF THE FRANCIS CHENEY AND THREE RIVERS FAMILY HOUSES. PART X, LINE 2: ASANTE HAS RECEIVED A DETERMINATION LETTER FROM THE INTERNAL REVENUE SERVICE (IRS) STATING THAT IT IS EXEMPT FROM FEDERAL INCOME TAX UNDER SECTION 501(C)(3) OF THE INTERNAL REVENUE CODE (IRC), EXCEPT FOR UNRELATED BUSINESS INCOME. MANAGEMENT BELIEVES ASANTE IS OPERATED IN A MANNER THAT QUALIFIES FOR TAX-EXEMPT STATUS. INCOME TAXES ARE PROVIDED FOR THE TAX EFFECTS OF TRANSACTIONS RELATED TO ASANTE'S TAX-EXEMPT PURPOSE REPORTED IN THE CONSOLIDATED FINANCIAL STATEMENTS; HOWEVER, SUCH ACTIVITIES ARE NOT SIGNIFICANT TO THE CONSOLIDATED FINANCIAL STATEMENTS. ACCOUNTING PRINCIPLES GENERALLY ACCEPTED IN THE UNITED STATES OF AMERICA REQUIRE MANAGEMENT TO EVALUATE TAX POSITIONS TAKEN BY ASANTE AND RECOGNIZE A TAX LIABILITY (OR ASSET) IF ASANTE HAS TAKEN AN UNCERTAIN TAX POSITION THAT MORE LIKELY THAN NOT WOULD NOT BE SUSTAINED UPON EXAMINATION BY THE IRS. MANAGEMENT HAS ANALYZED TAX POSITIONS TAKEN BY ASANTE AND HAS CONCLUDED THAT AS OF SEPTEMBER 30, 2021, THERE ARE NO UNCERTAIN TAX POSITIONS TAKEN, OR EXPECTED TO BE TAKEN, THAT WOULD REQUIRE RECOGNITION OF A LIABILITY (OR AN ASSET) OR DISCLOSURE IN THE CONSOLIDATED FINANCIAL STATEMENTS. ASANTE IS SUBJECT TO ROUTINE AUDITS BY TAXING JURISDICTIONS; HOWEVER, NO SUCH AUDITS ARE CURRENTLY IN PROCESS. 1 1 X 1 X 1 X 1 1 0 1 1 8811382 1949201 6862181 0.00730 132624 244398115 178223323 66174792 0.07070 19973 56741589 43236446 13505143 0.01440 152597 309951086 223408970 86542116 0.09240 6533 11690513 364000 11326513 0.01210 2796736 4125 2792611 0.00300 29757986 18992838 10765148 0.01150 500739 12826 487913 0.00050 6533 44745974 19373789 25372185 0.02710 159130 354697060 242782759 111914301 0.11950 1 15231954 1812603 209667690 269041872 -59374182 X 1 1 1 CVI MANAGEMENT CO LLC MANAGEMENT SERVICES 0.25000 0.00000 0.75000 2 CVI REAL PROPERTY PROPERTY MANAGEMENT 0.25000 0.00000 0.75000 3 SURGERY CENTER OF SOUTHERN OREGON OUTPATIENT SURGERIES 0.20000 0.00000 0.80000 3 1 ROGUE REGIONAL MEDICAL CENTER 2825 E BARNETT ROAD MEDFORD OR 97504 WWW.ASANTE.ORG 14-0451 X X X 2 THREE RIVERS MEDICAL CENTER 500 SW RAMSEY AVENUE GRANTS PASS OR 97527 WWW.ASANTE.ORG 14-1439 X X X 3 ASHLAND COMMUNITY HOSPITAL 280 MAPLE STREET ASHLAND OR 97520 WWW.ASANTE.ORG 14-1445 X X X ROGUE REGIONAL MEDICAL CENTER 1 0 0 1 X X X X X X X X X 18 1 1 1 1 X WWW.ASANTE.ORG/ABOUT-US/COMMUNITY-HEALTH-NEEDS-ASSESSMENT/ X 1 18 1 WWW.ASANTE.ORG/ABOUT-US/COMMUNITY-HEALTH-NEEDS-ASSESSMENT/ 0 1 X 200.000000000000 400.000000000000 X X X 1 1 X X X 1 X WWW.ASANTE.ORG/PATIENTS-VISITORS/BILLING-AND-FINANCIAL-ASSISTANCE/ X WWW.ASANTE.ORG/PATIENTS-VISITORS/BILLING-AND-FINANCIAL-ASSISTANCE/ X WWW.ASANTE.ORG/PATIENTS-VISITORS/BILLING-AND-FINANCIAL-ASSISTANCE/ X X X X X X X 1 X 0 X X X X 1 X 0 0 THREE RIVERS MEDICAL CENTER 2 0 0 1 X X X X X X X X X 18 1 1 1 1 X WWW.ASANTE.ORG/ABOUT-US/COMMUNITY-HEALTH-NEEDS-ASSESSMENT/ X 1 18 1 WWW.ASANTE.ORG/ABOUT-US/COMMUNITY-HEALTH-NEEDS-ASSESSMENT/ 0 1 X 200.000000000000 400.000000000000 X X X 1 1 X X X 1 X WWW.ASANTE.ORG/PATIENTS-VISITORS/BILLING-AND-FINANCIAL-ASSISTANCE/ X WWW.ASANTE.ORG/PATIENTS-VISITORS/BILLING-AND-FINANCIAL-ASSISTANCE/ X WWW.ASANTE.ORG/PATIENTS-VISITORS/BILLING-AND-FINANCIAL-ASSISTANCE/ X X X X X X X 1 X 0 X X X X 1 X 0 0 ASHLAND COMMUNITY HOSPITAL 3 0 0 1 X X X X X X X X X 18 1 1 1 1 X WWW.ASANTE.ORG/ABOUT-US/COMMUNITY-HEALTH-NEEDS-ASSESSMENT/ X 1 18 1 WWW.ASANTE.ORG/ABOUT-US/COMMUNITY-HEALTH-NEEDS-ASSESSMENT/ 0 1 X 200.000000000000 400.000000000000 X X X 1 1 X X X 1 X WWW.ASANTE.ORG/PATIENTS-VISITORS/BILLING-AND-FINANCIAL-ASSISTANCE/ X WWW.ASANTE.ORG/PATIENTS-VISITORS/BILLING-AND-FINANCIAL-ASSISTANCE/ X WWW.ASANTE.ORG/PATIENTS-VISITORS/BILLING-AND-FINANCIAL-ASSISTANCE/ X X X X X X X 1 X 0 X X X X 1 X 0 0 ROGUE REGIONAL MEDICAL CENTER PART V, SECTION B, LINE 5: AS PART OF THE PATIENT PROTECTION AND AFFORDABLE CARE ACT'S REQUIREMENT TO CONDUCT A COMMUNITY HEALTH NEEDS ASSESSMENT EVERY THREE YEARS, ASANTE, ROGUE REGIONAL MEDICAL CENTER, ASHLAND COMMUNITY HOSPITAL, AND THREE RIVERS MEDICAL CENTER PARTNERED WITH PROFESSIONAL RESEARCH CONSULTANTS, INC. TO COMPLETE 600 COMMUNITY SURVEYS IN TAX YEAR 2018. THAT YEAR, WE ALSO HELD A FOCUS GROUP COMPRISED OF 13 KEY COMMUNITY LEADERS FROM JACKSON AND JOSEPHINE COUNTIES. THE FOCUS GROUP DISCUSSED THE INDIVIDUAL LEADERS' EXPERIENCES AND PERCEPTIONS OF THE TOP HEALTH CONCERNS IN OUR COMMUNITY. THREE RIVERS MEDICAL CENTER PART V, SECTION B, LINE 5: AS PART OF THE PATIENT PROTECTION AND AFFORDABLE CARE ACT'S REQUIREMENT TO CONDUCT A COMMUNITY HEALTH NEEDS ASSESSMENT EVERY THREE YEARS, ASANTE, ROGUE REGIONAL MEDICAL CENTER, ASHLAND COMMUNITY HOSPITAL, AND THREE RIVERS MEDICAL CENTER PARTNERED WITH PRC TO COMPLETE 600 COMMUNITY SURVEYS IN TAX YEAR 2018. THAT YEAR, WE ALSO HELD A FOCUS GROUP COMPRISED OF 7 KEY COMMUNITY LEADERS FROM JACKSON AND JOSEPHINE COUNTIES. THE FOCUS GROUP DISCUSSED THE INDIVIDUAL LEADERS' EXPERIENCES AND PERCEPTIONS OF THE TOP HEALTH CONCERNS IN OUR COMMUNITY. ASHLAND COMMUNITY HOSPITAL PART V, SECTION B, LINE 5: AS PART OF THE PATIENT PROTECTION AND AFFORDABLE CARE ACT'S REQUIREMENT TO CONDUCT A COMMUNITY HEALTH NEEDS ASSESSMENT EVERY THREE YEARS, ASANTE, ROGUE REGIONAL MEDICAL CENTER, ASHLAND COMMUNITY HOSPITAL, AND THREE RIVERS MEDICAL CENTER PARTNERED WITH PRC TO COMPLETE 600 COMMUNITY SURVEYS IN TAX YEAR 2018. THAT YEAR, WE ALSO HELD A FOCUS GROUP COMPRISED OF 7 KEY COMMUNITY LEADERS FROM JACKSON AND JOSEPHINE COUNTIES. THE FOCUS GROUP DISCUSSED THE INDIVIDUAL LEADERS' EXPERIENCES AND PERCEPTIONS OF THE TOP HEALTH CONCERNS IN OUR COMMUNITY. ROGUE REGIONAL MEDICAL CENTER PART V, SECTION B, LINE 6A: ASANTE ASHLAND COMMUNITY HOSPITAL IN ASHLAND, OREGON AND THREE RIVERS MEDICAL CENTER IN GRANTS PASS, OREGON THREE RIVERS MEDICAL CENTER PART V, SECTION B, LINE 6A: ASANTE ASHLAND COMMUNITY HOSPITAL IN ASHLAND, OREGON AND ROGUE REGIONAL MEDICAL CENTER IN MEDFORD, OREGON ASHLAND COMMUNITY HOSPITAL PART V, SECTION B, LINE 6A: ROGUE REGIONAL MEDICAL CENTER IN MEDFORD, OREGON AND THREE RIVERS MEDICAL CENTER IN GRANTS PASS, OREGON ROGUE REGIONAL MEDICAL CENTER PART V, SECTION B, LINE 6B: THE CHNA WAS CONDUCTED WITH THE FOLLOWING ORGANIZATIONS WHICH ARE NOT HOSPITAL FACILITIES: ACCESS ADDICTIONS RECOVERY CENTER (ARC), CASA OF JACKSON COUNTY, CHILDREN'S ADVOCACY CENTER OF JACKSON COUNTY, FOOD & FRIENDS ROGUE VALLEY, COUNCIL OF GOVERNMENTS, FORMER JACKSON COUNTY COMMISSIONER, HEARTS WITH A MISSION, JEFFERSON REGIONAL HEALTH ALLIANCE, JWA PUBLIC AFFAIRS, NORTH MEDFORD HIGH SCHOOL, ROGUE VALLEY FAMILY, YMCA, UNITED WAY OF JACKSON COUNTY THREE RIVERS MEDICAL CENTER PART V, SECTION B, LINE 6B: THE CHNA WAS CONDUCTED WITH THE FOLLOWING ORGANIZATIONS WHICH ARE NOT HOSPITAL FACILITIES: ACCESS ADDICTIONS RECOVERY CENTER (ARC), CASA OF JACKSON COUNTY, CHILDREN'S ADVOCACY CENTER OF JACKSON COUNTY, FOOD & FRIENDS ROGUE VALLEY, COUNCIL OF GOVERNMENTS, FORMER JACKSON COUNTY COMMISSIONER, HEARTS WITH A MISSION, JEFFERSON REGIONAL HEALTH ALLIANCE, JWA PUBLIC AFFAIRS, NORTH MEDFORD HIGH SCHOOL, ROGUE VALLEY FAMILY, YMCA, UNITED WAY OF JACKSON COUNTY. ASHLAND COMMUNITY HOSPITAL PART V, SECTION B, LINE 6B: THE CHNA WAS CONDUCTED WITH THE FOLLOWING ORGANIZATIONS WHICH ARE NOT HOSPITAL FACILITIES: ACCESS ADDICTIONS RECOVERY CENTER (ARC), CASA OF JACKSON COUNTY, CHILDREN'S ADVOCACY CENTER OF JACKSON COUNTY, FOOD & FRIENDS ROGUE VALLEY, COUNCIL OF GOVERNMENTS, FORMER JACKSON COUNTY COMMISSIONER, HEARTS WITH A MISSION, JEFFERSON REGIONAL HEALTH ALLIANCE, JWA PUBLIC AFFAIRS, NORTH MEDFORD HIGH SCHOOL, ROGUE VALLEY FAMILY, YMCA, UNITED WAY OF JACKSON COUNTY ROGUE REGIONAL MEDICAL CENTER PART V, SECTION B, LINE 11: IN ROGUE REGIONAL MEDICAL CENTER'S MOST RECENT COMMUNITY HEALTH NEEDS ASSESSMENT, THE IDENTIFIED SIGNIFICANT COMMUNITY HEALTH NEEDS WERE ACCESS TO HEALTHCARE SERVICES, SUBSTANCE ABUSE, MENTAL HEALTH, CARDIOVASCULAR DISEASE AND STROKE, AND INFANT HEALTH. HOWEVER, ROGUE REGIONAL MEDICAL CENTER'S EFFORTS DURING THE FISCAL YEAR WERE ENTIRELY DEDICATED TO PROVIDING AN EFFECTIVE RESPONSE TO THE COVID PANDEMIC. THREE RIVERS MEDICAL CENTER PART V, SECTION B, LINE 11: IN THREE RIVERS MEDICAL CENTER'S MOST RECENT COMMUNITY HEALTH NEEDS ASSESSMENT, THE IDENTIFIED SIGNIFICANT COMMUNITY HEALTH NEEDS WERE ACCESS TO HEALTHCARE SERVICES, SUBSTANCE ABUSE, MENTAL HEALTH, CARDIOVASCULAR DISEASE AND STROKE, AND INFANT HEALTH. HOWEVER, THREE RIVERS MEDICAL CENTER'S EFFORTS DURING THE FISCAL YEAR WERE ENTIRELY DEDICATED TO PROVIDING AN EFFECTIVE RESPONSE TO THE COVID PANDEMIC. ASHLAND COMMUNITY HOSPITAL PART V, SECTION B, LINE 11: IN ASHLAND COMMUNITY HOSPITAL'S MOST RECENT COMMUNITY HEALTH NEEDS ASSESSMENT, THE IDENTIFIED SIGNIFICANT COMMUNITY HEALTH NEEDS WERE ACCESS TO HEALTHCARE SERVICES, SUBSTANCE ABUSE, MENTAL HEALTH, CARDIOVASCULAR DISEASE AND STROKE, AND INFANT HEALTH. HOWEVER, ASHLAND COMMUNITY HOSPITAL'S EFFORTS DURING THE FISCAL YEAR WERE ENTIRELY DEDICATED TO PROVIDING AN EFFECTIVE RESPONSE TO THE COVID PANDEMIC. ROGUE REGIONAL MEDICAL CENTER PART V, SECTION B, LINE 16J: PARTIAL INFORMATION, BUT NOT THE ENTIRE POLICY, ABOUT APPLYING FOR FINANCIAL AID IS PRINTED ON THE PATIENT'S BILLING STATEMENT. THE ENTIRE FINANCIAL ASSISTANCE POLICY IS POSTED ON THE ASANTE WEBSITE AT WWW.ASANTE.ORG. THE ENTIRE POLICY IS ALSO ON POSTERS IN THE PATIENT REGISTRATION DEPARTMENT. IF A PATIENT WISHES TO APPLY FOR FINANCIAL AID, THEY ARE DIRECTED TO CALL THE HOSPITAL FOR A FINANCIAL ASSISTANCE APPLICATION. THREE RIVERS MEDICAL CENTER PART V, SECTION B, LINE 16J: PARTIAL INFORMATION, BUT NOT THE ENTIRE POLICY, ABOUT APPLYING FOR FINANCIAL AID IS PRINTED ON THE PATIENT'S BILLING STATEMENT. THE ENTIRE FINANCIAL ASSISTANCE POLICY IS POSTED ON THE ASANTE WEBSITE AT WWW.ASANTE.ORG. THE ENTIRE POLICY IS ALSO ON POSTERS IN THE PATIENT REGISTRATION DEPARTMENT. IF A PATIENT WISHES TO APPLY FOR FINANCIAL AID, THEY ARE DIRECTED TO CALL THE HOSPITAL FOR A FINANCIAL ASSISTANCE APPLICATION. ASHLAND COMMUNITY HOSPITAL PART V, SECTION B, LINE 16J: PARTIAL INFORMATION, BUT NOT THE ENTIRE POLICY, ABOUT APPLYING FOR FINANCIAL AID IS PRINTED ON THE PATIENT'S BILLING STATEMENT. THE ENTIRE FINANCIAL ASSISTANCE POLICY IS POSTED ON THE ASANTE WEBSITE AT WWW.ASANTE.ORG. THE ENTIRE POLICY IS ALSO ON POSTERS IN THE PATIENT REGISTRATION DEPARTMENT. IF A PATIENT WISHES TO APPLY FOR FINANCIAL AID, THEY ARE DIRECTED TO CALL THE HOSPITAL FOR A FINANCIAL ASSISTANCE APPLICATION. ROGUE REGIONAL MEDICAL CENTER PART V, SECTION B, LINE 18E: ROGUE REGIONAL MEDICAL CENTER'S "POLICY" IS TO ALLOW THIRD PARTIES TO PERFORM LAWSUITS, PLACE LIENS ON RESIDENCES, AND GARNISH WAGES, BUT ONLY AS A FINAL RESORT. HOWEVER, THE ASANTE BUSINESS OFFICE IS AUTHORIZED TO PLACE A VOLUNTARY LIEN ON A PATIENTS RESIDENCE ON CERTAIN RARE CIRCUMSTANCES. THE PATIENT MUST APPROVE THE VOLUNTARY LIEN FIRST. THREE RIVERS MEDICAL CENTER PART V, SECTION B, LINE 18E: THREE RIVERS MEDICAL CENTER'S "POLICY" IS TO ALLOW THIRD PARTIES TO PERFORM LAWSUITS, PLACE LIENS ON RESIDENCES, AND GARNISH WAGES, BUT ONLY AS A FINAL RESORT. HOWEVER, THE ASANTE BUSINESS OFFICE IS AUTHORIZED TO PLACE A VOLUNTARY LIEN ON A PATIENTS RESIDENCE ON CERTAIN RARE CIRCUMSTANCES. THE PATIENT MUST APPROVE THE VOLUNTARY LIEN FIRST. ASHLAND COMMUNITY HOSPITAL PART V, SECTION B, LINE 18E: ASANTE ASHLAND COMMUNITY HOSPITAL'S "POLICY" IS TO ALLOW THIRD PARTIES TO PERFORM LAWSUITS, PLACE LIENS ON RESIDENCES, AND GARNISH WAGES, BUT ONLY AS A FINAL RESORT. HOWEVER, THE ASANTE BUSINESS OFFICE IS AUTHORIZED TO PLACE A VOLUNTARY LIEN ON A PATIENTS RESIDENCE ON CERTAIN RARE CIRCUMSTANCES. THE PATIENT MUST APPROVE THE VOLUNTARY LIEN FIRST. ROGUE REGIONAL MEDICAL CENTER PART V, SECTION B, LINE 20E: NOTIFY INDIVIDUALS OF FINANCIAL ASSISTANCE PRIOR TO DISCHARGE THREE RIVERS MEDICAL CENTER PART V, SECTION B, LINE 20E: NOTIFY INDIVIDUALS OF FINANCIAL ASSISTANCE PRIOR TO DISCHARGE ASHLAND COMMUNITY HOSPITAL PART V, SECTION B, LINE 20E: NOTIFY INDIVIDUALS OF FINANCIAL ASSISTANCE PRIOR TO DISCHARGE 1 1 - ROGUE VALLEY RX 2900 E BARNETT ROAD MEDFORD OR 97504 OUTPATIENT PHARMACY PART I, LINE 3C: UNINSURED AND UNDERINSURED PATIENTS MAY BE ELIGIBLE FOR FINANCIAL ASSISTANCE FROM ASANTE IF (A) THE PATIENT COMPLETES ASANTE'S FINANCIAL ASSISTANCE PROGRAM APPLICATION AND PROVIDES ALL REQUIRED DOCUMENTATION, (B) THE PATIENT'S HOUSEHOLD INCOME, ADJUSTED FOR FAMILY SIZE, IS NOT MORE THAN 400% OF THE FPL, SO LONG AS NO OTHER FINANCIAL RESOURCES ARE AVAILABLE, AND (B) SERVICES PROVIDED ARE MEDICALLY NECESSARY INCLUDING BUT NOT LIMITED TO TREATMENT FOR EMERGENCY MEDICAL CONDITIONS. EXCEPTIONS CAN BE MADE FOR CERTAIN NON-MEDICALLY NECESSARY SERVICES TO TREAT LIFE THREATENING ILLNESSES SUCH AS CANCER DIAGNOSES OR OTHER HIGH ACUITY SERVICES. THESE DETERMINATIONS ARE MADE BY ASANTE ON A CASE BY CASE BASIS. IT IS IMPORTANT TO NOTE THE FOLLOWING SCENARIOS WHERE FINANCIAL ASSISTANCE IS NOT AVAILABLE: (A) SERVICES CONSIDERED NON-COVERED OR NOT MEDICALLY NECESSARY BY THE OREGON DEPARTMENT OF MEDICAL ASSISTANCE PROGRAMS (DMAP) PRIORITIZED LIST OF HEALTH SERVICES;(B) PATIENTS WHO HAVE INSURANCE BUT CHOOSE NOT TO UTILIZE THEIR COVERAGE;(C) ELECTIVE SURGERY OR PROCEDURES;(D) PATIENT COSTS THAT ARE COVERED BY OTHER AGENCIES (E.G. COMMUNITY/AGENCY FUNDED SUPPORT);(E) IF THE PATIENT FAILS TO RESPOND TO REQUESTS FROM HIS OR HER PRIMARY INSURER AS NECESSARY FOR THE INSURER TO ADJUDICATE A CLAIM FOR REIMBURSEMENT OF THE COST OF SERVICES; AND(F) IF THE PATIENT REFUSES OR FAILS TO PROVIDE INFORMATION CONCERNING ANY POTENTIAL THIRD- PARTY LIABILITY FOR THE COST OF SERVICES INCLUDING BUT NOT LIMITED TO: (A) INFORMATION ABOUT THE COORDINATION OF BENEFITS BETWEEN INSURERS THAT COVER THE PATIENT'S CARE; (B) ACCIDENT REPORTS; AND (C) THE PATIENT'S WORKERS' COMPENSATION CLAIMS OR BENEFITS. PART I, LINE 7: COST TO CHARGE RATIO IS USED TO CALCULATE COMMUNITY BENEFIT EXPENSES. PART I, LINE 7G: SUBSIDIZED SERVICES INCLUDE BEHAVIORAL HEALTH AND EMERGENCY SERVICES, WHICH INCLUDES SOUTHERN OREGON TRAUMA AND EMERGENCY SERVICES (SOTES) AND DISASTER EMERGENCY (COVID-19) DEPARTMENTS. PART I, LINE 7, COLUMN (F): THE BAD DEBT EXPENSE INCLUDED ON FORM 990, PART IX, LINE 25, COLUMN (A), BUT SUBTRACTED FOR PURPOSES OF CALCULATING THE PERCENTAGE IN THIS COLUMN IS $ 15,226,195. PART III, LINE 2: COST-TO-CHARGE RATIO PART III, LINE 3: ASANTE ESTIMATES THE AMOUNT OF BAD DEBT EXPENSE ATTRIBUTABLE TO PATIENTS WHO ARE ELIGIBLE FOR FINANCIAL ASSISTANCE BUT FAILED TO COMPLETE AN APPLICATION USING THE POVERTY RATE IN OUR SERVICE AREA AS PUBLISHED BY THE U.S. CENSUS BUREAU. IN 2021, 11.9% OF OUR COMMUNITY WAS AT OR BELOW THE FEDERAL POVERTY LEVEL, SO THAT PERCENTAGE OF BAD DEBT IS ASSUMED TO BE PART OF MISSED CHARITY CARE. PART III, LINE 4: BAD DEBT EXPENSE IS REPORTED BASED ON GROSS PATIENT CHARGES THAT HAVE BEEN WRITTEN OFF DUE TO NON-PAYMENT. PART III, LINE 8: CERTAIN GOVERNMENT SPONSORED HEALTH INSURANCE COMPANIES, SUCH AS MEDICARE AND MEDICAID, PAY A SIGNIFICANTLY REDUCED AMOUNT FOR MEDICAL SERVICES RENDERED TO THEIR INSUREES. OREGON LAW IN ORS 442.200 (2) CONSIDERS THE DIFFERENCE BETWEEN THE EXPENSES AND REIMBURSEMENT WITH RESPECT TO MEDICARE AND MEDICAID PATIENTS TO BE COMMUNITY BENEFIT. CALCULATION: TOTAL MEDICARE PAYMENTS PER COST REPORT LESS TOTAL MEDICARE COSTS PER COST REPORT = UNRECOVERED MEDICARE COST PER COST REPORT. PART III, LINE 9B: IF THERE IS AN INDICATION THAT A PATIENT MAY BE UNABLE TO PAY THEIR BILL, A FINANCIAL QUESTIONNAIRE IS GIVEN OR SENT TO THE PATIENT. ON RECEIPT OF THE COMPLETED QUESTIONNAIRE, THE BUSINESS OFFICE WILL DETERMINE ELIGIBILITY FOR FINANCIAL ASSISTANCE AND NOTIFY THE PATIENT WITHIN 20 DAYS. ELIGIBILITY IS DETERMINED BASED UPON THE QUESTIONNAIRE AND ON FINANCIAL DOCUMENTS, SUCH AS TAX RETURNS, SSI STATEMENTS, PAYCHECK STUBS, AND FSA/HSA INFORMATION. THE PATIENT'S OTHER FINANCIAL OBLIGATIONS, NUMBER OF DEPENDENTS, ASSETS AND OTHER FINANCIAL CIRCUMSTANCES ARE CONSIDERED. OFTEN, A PATIENT WILL NOT PROVIDE A FINANCIAL QUESTIONNAIRE, SO THE BUSINESS OFFICE WILL USE SOFT CREDIT CHECKS AND ZIP CODES+4 TO HELP DETERMINE ELIGIBILITY. THE PERCENTAGE OF FINANCIAL ASSISTANCE PROVIDED IS BASED UPON A SLIDING SCALE TABLE THAT UTILIZES THE PATIENT FAMILY'S INCOME AS A PERCENTAGE OF THE FEDERAL POVERTY GUIDELINES. PART VI, LINE 2: ASANTE'S FIVE PRIMARY SOURCES OF INPUT INCLUDE THE COMMUNITY LEADERS FORUM, THE ENVIRONMENTAL ASSESSMENT, THE COMMUNITY ASSESSMENT SURVEY, FORMAL CONVERSATIONS WITH OUR COLLABORATORS, AND IDENTIFIED STRATEGIC PLAN GAPS FROM THE PREVIOUS YEAR. PART VI, LINE 3: THE FINANCIAL ACCESS SPECIALISTS, CREDIT ANALYSTS, AND REGISTRATION PERSONNEL WORK WITH THE PATIENT EITHER AT THE TIME OF SCHEDULING, ARRIVAL AT THE HOSPITAL, OR DURING THE BILLING PROCESS. IF THE PATIENT DISCLOSES THEY WILL HAVE DIFFICULTY PAYING, WE ASSIST THEM APPLYING FOR THE OREGON HEALTH PLAN, FINANCIAL ASSISTANCE, OR A PAYMENT PLAN. BASED UPON INCOME AND EXPENSES, A PATIENT MAY BE ELIGIBLE FOR CHARITY CARE WRITE-OFF OF BETWEEN 10% AND 100% OF THEIR BILL. PART VI, LINE 4: THE MOST NOTABLE FACT ABOUT THE DEMOGRAPHICS OF OUR SERVICE AREA IS THAT WE HAVE A RATHER ELDERLY POPULATION, BOTH IN OUR PRIMARY SERVICE AREA OF JACKSON AND JOSEPHINE COUNTIES, BUT ALSO OUR SECONDARYVSERVICE AREA OF NORTHERN CALIFORNIA AND SOUTHERN OREGON. IN FISCAL 2020, PATIENTS 65+ ACCOUNTED FOR 54.08%, 52.74% AND 53.78% OF ADMISSIONS AT ACH, RRMC AND TRMC RESPECTIVELY. FOR THE NEXT 20 YEARS, THE 65+ AGE GROUP IS FORECAST TO BE THE FASTEST GROWING SEGMENT OF THE POPULATION. IN ADDITION, THE OVERALL POPULATION GROWTH OF OUR PRIMARY SERVICE AREA IS ALSO FORECAST TO AVERAGE 1 % PER YEAR FOR THE NEXT 30 YEARS. PART VI, LINE 6: ASANTE IS A COMMUNITY-OWNED AND -GOVERNED NOT-FOR-PROFIT HEALTH SYSTEM PROVIDING COMPREHENSIVE HEALTHCARE SERVICES TO MORE THAN 550,000 RESIDENTS IN NINE COUNTIES THROUGHOUT SOUTHERN OREGON AND NORTHERN CALIFORNIA. THE SYSTEM WAS FORMED IN 1995 TO INCLUDE ROGUE REGIONAL MEDICAL CENTER (RRMC) IN MEDFORD, AND THREE RIVERS MEDICAL CENTER (TRMC) IN GRANTS PASS. IN 2013, ASHLAND COMMUNITY HOSPITAL (ACH) IN ASHLAND WAS AQUIRED TO BETTER SERVE JACKSON COUNTY. PART VI, LINE 7, REPORTS FILED WITH STATES OR 1 ACCESS FOOD BANK 3630 AVIATION WAY MEDFORD OR 97504 930665396 501(C)(3) 70200 SUPPORT JACKSON COUNTY FOOD BANK. JOSEPHINE COUNTY FOOD BANK PO BOX 250 GRANTS PASS OR 97528 471904505 501(C)(3) 20000 SUPPORT JOSEPHINE COUNTY FOOD BANK. GRANTS PASS SOBERING CENTER PO BOX 1388 GRANTS PASS OR 97528 464365248 501(C)(3) 30000 SUPPORT ESSENTIAL SERVICES PROVIDED TO SUPPORT CITIZENS NAVIGATING ADDICTION IN GRANTS PASS. JACKSON COUNTY SART 2305 ASHLAND STREET ASHLAND OR 97520 810650183 501(C)(3) 42300 TRAINING AND PROVISION OF SEXUAL ASSUALT RESPONSE TEAM (SART) NURSES TO PROVIDE FREE EXAMINATIONS, EMOTIONAL SUPPORT AND EVIDENCE COLLECTION. MASLOW PROJECT 500 MONROE STREET MEDFORD OR 97501 270734969 501(C)(3) 50000 MASLOW PROJECT'S MISSION IS TO OFFER EVERY HOMELESS CHILD AND YOUTH THE PROBABILITY OF SUCCESS AND THE OPPORTUNITY FOR A BETTER LIFE. THEY DO THIS BY PROVIDING RESOURCES FOR BASIC NEEDS, REMOVING BARRIERS TO EDUCATION AND EMPLOYMENT, AND FOSTERING SELF-SUFFICIENCY IN A COLLABORATIVE AND EMPOWERING ENVIRONMENT. CHILDREN'S MIRACLE NETWORK 205 WEST 700 SOUTH SALT LAKE CITY UT 84101 870387205 501(C)(3) 19674 CMN SUPPORT. YMCA OF MEDFORD OREGON 522 W SIXTH STREET MEDFORD OR 97501 930391645 501(C)(3) 10000 ENCOURAGE FITNESS FOR COMMUNITY MEMEBERS OF ALL AGES. 7 0 PART I, LINE 2: WHEN ASANTE RECEIVES A REQUEST FOR GRANT FUNDS FROM AN OUTSIDE ORGANIZATION, THE REQUEST IS REVIEWED BY EITHER THE JACKSON COUNTY OR JOSEPHINE COUNTY COMMUNITY CONNECTIONS COMMITTEE. THE APPLICANT MUST FILL OUT AN APPLICATION FORM AND PROVIDE SUPPORTING DOCUMENTS OR EVENT MATERIALS. TO BE SELECTED, THE ORGANIZATION MUST MEET THE FOLLOWING CRITERIA: 1)THE GRANT MUST SUPPORT STRATEGIC INITIATIVES, 2)IT MUST HAVE A DIRECT IMPACT ON THE HEALTHCARE OF THE COMMUNITY, 3)THE ORGANIZATION MUST BE A NOT-FOR-PROFIT HEALTH, HUMAN SERVICES, OR EDUCATION RELATED ORGANIZATION, 4 )THE ORGANIZATION COLLABORATES WITH OTHER NOT-FOR-PROFIT ORGANIZATIONS AND, 5)THE GRANT MUST BE A RELATION BUILDING OPPORTUNITY. ONCE AN APPLICANT HAS BEEN APPROVED FOR GRANT FUNDS, THE GRANT AGREEMENT SPECIFIES THAT ALL GRANT MONIES ARE TO BE SPENT FOR ONLY THE PURPOSE SPELLED OUT IN THE APPLICATION. THE COUNTY CONNECTIONS COMMITTEE MUST KNOW WHERE THE DONATED MONEY WILL BE ALLOCATED, AND IF A FUNDRAISING EVENT, HOW THE RAISED MONEY WILL BE ALLOCATED. USUALLY, A DETAILED BUDGET OF THE GRANTEE'S CURRENT YEAR IS REQUIRED, AS WELL AS ANY REPORTS OR MINUTES FROM PREVIOUS EVENTS. X X X X X 0 1 0 0 0 0 0 0 0 SCOTT KELLY PRESIDENT & CEO 883947 0 255999 0 52542 0 17100 0 15628 0 1225216 0 0 0 GREG WOJTAL CAFO 529587 0 109602 0 64483 0 17100 0 22080 0 742852 0 0 0 JAMES GREBOSKY CMO & ACH CEO 509244 0 96800 0 0 0 17100 0 31667 0 654811 0 0 0 MICK ZDEBLICK RRMC CEO 497000 0 103840 0 0 0 17100 0 24848 0 642788 0 0 0 LEE MILLIGAN MD CIO 449630 0 95259 0 0 0 17100 0 27170 0 589159 0 0 0 ERIC LOELIGER MD VP, MEDICAL AFFAIRS - TRMC 406755 0 50325 0 71966 0 17100 0 35720 0 581866 0 0 0 COURTNEY WILSON MD MEDICAL DOCTOR 449271 0 16662 0 15321 0 17100 0 30324 0 528678 0 0 0 WIN HOWARD TRMC CEO 413292 0 65913 0 0 0 17100 0 32045 0 528350 0 0 0 DENNIE CONRAD CSO 353552 0 74140 0 25116 0 17100 0 26438 0 496346 0 0 0 CHRIS DAVID MD MEDICAL DOCTOR 386998 0 8812 0 15321 0 17100 0 30576 0 458807 0 0 0 JENNIFER HALL MD MEDICAL DOCTOR 388290 0 17109 0 1 0 17100 0 30490 0 452990 0 0 0 DANIELLE HOLTZ MD MEDICAL DOCTOR 386553 0 17740 0 0 0 8774 0 17706 0 430773 0 0 0 ROY VINYARD FORMER PRESIDENT & CEO 103096 0 120000 0 0 0 13662 0 20668 0 257426 0 0 0 SHEILA CLOUGH FORMER ACH CEO 157739 0 68640 0 0 0 13727 0 13829 0 253935 0 0 0 PART I, LINE 4B ASANTE HAS AN EXECUTIVE RESTORATION PLAN WHICH INCLUDES ASANTE VP & CIO LEE MILLIGAN, MD, ARRMC CEO SCOTT KELLY, ATRMC CEO WIN HOWARD, AACH CEO SHEILA CLOUGH, CHIEF MEDICAL OFFICER AND ACH CEO JAMES GREBOSKY, MD, VP OF MEDICAL AFFAIRS ERIC LOELIGER, MD, AND CSO DENNIE CONRAD. THIS PLAN STATES FIXED PAYMENTS WILL BE RECEIVED AT PRE-DETERMINED INTERVALS FROM ASANTE IF STILL EMPLOYED BY ASANTE IN THEIR CURRENT ROLL AT THE TIME OF VESTING. IF EMPLOYMENT TERMINATES BY ASANTE FOR ANY REASON PRIOR TO VESTING, THEY WILL NOT HAVE CLAIM TO THE FUNDS. SELECT EXECUTIVES AGREED TO PARTICIPATE IN CAP-EX IN PLACE OF A TRADITIONAL SERP. SEE SCHEDULE L, PART V, FOR A BROADER DESCRIPTION. A THE HOSPITAL FACILITIES AUTHORITY OF THE CITY OF MEDFORD OR 521378932 794458FX2 2020-07-21 524570640 SEE PART VI 0 0 0 A 524585384 1923423 116411659 208130623 198119679 1 0 0 1 A 0 1 1 1 1 1 0.00000 0.00000 0.00000 0 0 1 A 0 1 1 0 1 0 0 0 1 A 0 PART I, COLUMN F: THE BONDS WERE ISSUED TO PAY COSTS OF IMPROVEMENTS TO THE BORROWER'S HOSPITAL FACILITIES, AND CURRENT REFUND A PORTION OF THE ISSUER'S OUTSTANDING HOSPITAL REVENUE BONDS, SERIES 2010 AND SERIES 2005A (REISSUED) ORIGINALLY ISSUED ON FEBRUARY 17, 2010 AND ALL OF THE ISSUER'S HOSPITAL REVENUE BONDS, SERIES 2002B ORIGINALLY ISSUED ON FEBRUARY 5, 2002. PART II, LINE 3: THE AMOUNT DIFFERS FROM THE ISSUE PRICE IN PART I, COLUMN E DUE TO INTEREST EARNINGS ON INVESTED PROCEEDS. PART III, LINE 7: AS PROVIDED IN TREASURY REGULATION SECTION 1.141-4(C)(2)(I)(B), THE AMOUNT OF PRIVATE PAYMENTS TAKEN INTO ACCOUNT UNDER THE PRIVATE PAYMENT TEST MAY NOT EXCEED THE AMOUNT OF PRIVATE BUSINESS USE AND/OR UNRELATED TRADE OR BUSINESS USE. ACCORDINGLY, THE AMOUNT OF PRIVATE PAYMENTS FOR THE REPORTING PERIOD DOES NOT EXCEED THE AMOUNT STATED IN PART III, LINE 6. THE ORGANIZATION HAS NOT UNDERTAKEN AN ANALYSIS OF THE PRIVATE SECURITY TEST WITH RESPECT TO THE BONDS, AS THE LEVEL OF USE AND/OR UNRELATED TRADE OR BUSINESS REPORTED IN PART III, LINE 6, IS NOT IN EXCESS OF AMOUNTS PERMITTED UNDER SECTION 145 OF THE CODE. PART IV, LINE 2B: THE REFUNDING PORTION OF BONDS HAS MET THE 6-MONTH EXPENDITURE EXCEPTION TO REBATE. ROY VINYARD FORMER ASANTE CEO SEE PART V X 3000000 5487821 0 1 1 5487821 ROGUE DISPOSAL ROGUE DISPOSAL IS OWNED BY THE FAMILY OF STEPHEN GAMBEE, BOARD MEMBER 1457874 GARBAGE DISPOSAL SERVICES 0 PART II, COLUMN C: THE EO PROVIDES SUPPLEMENTAL RETIREMENT BENEFITS THROUGH AN ALTERNATIVE FUNDING ARRANGEMENT THE IRS CALLS "COLLATERAL ASSIGNMENT SPLIT DOLLAR" (CASD). ALTHOUGH THE IRS REQUIRES REPORTING IN THE LOAN SECTION OF SCHEDULE L, CASD IS NOT AN ACTUAL LOAN--NO FUNDS ARE TRANSFERRED TO THE EXECUTIVE. RATHER, THE "LOAN" TREATMENT APPLIES BECAUSE AFTER THE EXECUTIVE HAS RECEIVED RETIREMENT BENEFITS, THE EO RECOVERS ALL OF ITS OUTLAYS PLUS INTEREST.THE RECOVERY RIGHT IS A KEY ADVANTAGE OF CASD FOR THE EO. RATHER THAN PAYING RETIREMENT BENEFITS TO THE EXECUTIVE THAT WOULD NEVER BE RECOVERED, UNDER CASD THE EO RECOVERS NOT ONLY ITS OUTLAYS, BUT ALSO CONSIDERATION FOR THE TIME VALUE OF MONEY. CASD WORKS AS FOLLOWS. THE EO DEPOSITS FUNDS INTO A CASH VALUE LIFE INSURANCE POLICY ON THE EXECUTIVE'S LIFE. DURING LIFE, TO THE EXTENT THE EXECUTIVE FULFILLS SERVICE AND VESTING REQUIREMENTS, THE EXECUTIVE CAN BORROW AGAINST VALUES IN THE POLICY TO SUPPLEMENT RETIREMENT INCOME. POLICY PERFORMANCE IS CLOSELY MONITORED. IF POLICY PERFORMANCE LAGS, THE EXECUTIVE'S BORROWING RIGHTS ARE REDUCED TO PROTECT THE EO'S RECOVERY RIGHTS.AT THE EXECUTIVE'S DEATH, THE POLICY DEATH PROCEEDS ARE FIRST USED TO REPAY THE EO ITS DEPOSITS PLUS COMPOUNDED INTEREST (AT THE IRS LONG-TERM APPLICABLE FEDERAL RATE). THE EXECUTIVE'S BENEFICIARY THEN RECEIVES ANY PROJECTED RETIREMENT BORROWING THE EXECUTIVE DID NOT ACCESS DURING LIFE. ANY REMAINING DEATH PROCEEDS ARE AVAILABLE TO BE PAID TO THE EXECUTIVE'S BENEFICIARY. FORM 990, PART VI, SECTION B, LINE 11B THE FEDERAL FORMS 990 AND 990-T ARE FEDERALLY MANDATED LEGAL DOCUMENTS THAT ARE HIGHLY REGULATED. BEFORE FINAL SUBMISSION OF THE FORM 990, IT WAS REVIEWED BY THE SUPERVISOR OF FINANCE, DIRECTOR OF FINANCE AND CAFO. AFTER SUBMISSION, THE FINAL RETURNS WILL BE PRESENTED TO THE ASANTE BOARD OF DIRECTORS. FORM 990, PART VI, SECTION B, LINE 12C EACH YEAR, ASANTE MAILS TO ALL ASANTE MANAGEMENT, KEY EMPLOYEES, AND BOARD MEMBERS A CONFLICT OF INTEREST QUESTIONAIRE TO COMPLY WITH ASANTE'S CONFLICT OF INTEREST POLICY. THE PURPOSE OF THE POLICY IS TO PROTECT ASANTE'S INTERESTS WHEN IT IS CONTEMPLATING ENTERING INTO A TRANSACTION OR ARRANGEMENT THAT MIGHT BENEFIT THE PRIVATE INTERESTS OF A BOARD MEMBER OR OFFICER OF THE CORPORATION. IN ADDITION, ALL ASANTE EMPLOYEES HAVE AN OBLIGATION TO DISCLOSE CONFLICTS OF INTEREST OR POTENTIAL CONFLICTS TO THEIR SUPERVISOR. THE CORPORATE COMPLIANCE OFFICER IS RESPONSIBLE FOR ADMINISTERING, MONITORING, AND INVESTIGATING ANY POSSIBLE CONFLICTS AND MAKING AN ANNUAL REPORT TO THE BOARD OF DIRECTORS. FORM 990, PART VI, SECTION B, LINE 15 THE COMPENSATION COMMITTEE OF THE BOARD OF DIRECTORS ANNUALLY REVIEWS THE COMPENSATION OF THE CEO AND OTHER KEY EMPLOYEES. THE REVIEW COMPARES THE COMPENSATION OF THE CEO AND OTHER KEY EMPLOYEES WITH COMPENSATION DATA FOR JOB INCUMBENTS IN COMPARABLE POSITIONS AT OTHER HEALTHCARE ORGANIZATIONS OF SIMILAR SIZE AND SCOPE. AT LEAST EVERY TWO YEARS, THE REVIEW IS CONDUCTED AND PRESENTED TO THE COMPENSATION COMMITTEE BY AN OUTSIDE CONSULTANT, CHOSEN BY THE COMPENSATION COMMITTEE. ON ALTERNATE YEARS, THE GENERAL MARKET MOVEMENT IS CONSIDERED AND THE REVIEW IS COMPLETED AND PRESENTED BY THE VP OF HUMAN RESOURCES. THE COMPENSATION COMMITTEE SETS THE ACTUAL ANNUAL CASH COMPENSATION FOR THE CEO AND SALARY RANGES FOR THE OTHER KEY EMPLOYEES. THE COMMITTEE ALSO SETS TOTAL COMPENSATION OPPORTUNITY FOR THE CEO AND EACH OF THE KEY EMPLOYEES, CONSISTENT WITH THE EXECUTIVE COMPENSATION PHILOSOPHY. MINUTES OF THE COMMITTEE DELIBERATIONS AND DECISIONS ARE RECORDED AND MAINTAINED. THE MOST RECENT EXECUTIVE COMPENSATION REVIEW BY AN OUTSIDE CONSULTANT WAS COMPLETED IN 2019. THE VP OF HR PROVIDED THE UPDATE RECOMMENDATIONS IN 2020. FORM 990, PART VI, SECTION C, LINE 19 THE ORGANIZATION'S FINANCIAL STATEMENTS ARE AVAILABLE TO THE PUBLIC THROUGH EMMA AND AS A COMPONENT OF FILED FORMS 990. ASANTE ASHLAND COMMUNITY HOSPITAL 280 MAPLE STREET MEDFORD OR 97520 815427847 HEALTHCARE SERVICES OR 79996951 46912633 ASANTE ASANTE THREE RIVERS MEDICAL CENTER LLC 500 SW RAMSEY AVENUE GRANTS PASS OR 97527 571181758 HEALTHCARE SERVICES OR 221396686 87312237 ASANTE ASANTE COMMUNITY SERVICES LLC 2650 SISKIYOU BLVD MEDFORD OR 97504 571181752 HEALTHCARE SERVICES OR 0 0 ASANTE HEALTH ALLIANCE OF SOUTHERN OREGON 2620 E BARNETT ROAD MEDFORD OR 97504 371768822 MANAGE/IMPROVE POPULATION HEALTH OR 5730784 2379683 ASANTE SOUTHERN OREGON TRAUMA & EMERGENCY SERVICES 2650 SISKIYOU BLVD MEDFORD OR 97504 542085981 HEALTHCARE SERVICES OR 293789 16602 ASANTE ASANTE PHYSICIAN PARTNERS 2650 SISKIYOU BLVD MEDFORD OR 97504 383849354 PHYSICIAN GROUP OR 501(C)(3) LINE 3 ASANTE 1 ASANTE FOUNDATION 229 BARTLETT STREET MEDFORD OR 97504 936087366 FUNDRAISING OR 501(C)(3) LINE 12A, I ASANTE 1 SOUTHERN OREGON INSURANCE COMPANY 745 FORT STREET SUITE 800 HONOLULU HI 96813 201578637 CAPTIVE INSURANCE HI 501(C)(3) LINE 12B, II ASANTE 1 0 0 1 0 0 0 0 0 0 0 0 0 0 0 1 1 0 0 0 ASANTE FOUNDATION C 909097 CASH ASANTE FOUNDATION O 1264813 CASH ASANTE PHYSICIAN PARTNERS O 66853967 CASH SOUTHERN OREGON INSURANCE COMPANY P 3324184 CASH